经伤椎椎弓根6钉与跨伤椎椎弓根4钉内固定手术对A1型胸腰椎骨折脊柱稳定性的影响
Effects of Pedicle 6-Screw Internal Fixation through the Injured Vertebra and Pedicle 4-Screw Internal Fixation across the Injured Vertebra on Spinal Stability in A1 Type Thoracolumbar Fractures
陈博 1郭一帆 1衡立松2
作者信息
- 1. 陕西省商洛市中心医院脊柱外科,陕西 商洛 726000
- 2. 陕西省西安市红会医院创伤骨科上肢病区,陕西 西安 710000
- 折叠
摘要
目的:研究不同内固定手术对 A1 型胸腰椎骨折脊柱稳定性的影响.方法:回顾性分析2021 年1 月至2023 年1 月期间本院收治的146 例A1 型胸腰椎骨折患者的临床资料,根据内固定手术方式,将接受经伤椎椎弓根6 钉内固定手术的82 例患者纳入 A 组,将接受经跨伤椎椎弓根 4 钉内固定手术的64 例患者纳入B组.比较两组围术期指标、矢状面 Cobb 角、椎体高度压缩率、Oswestry 功能障碍指数(ODI)、应激指标、术后并发症.结果:A组术中出血量(248.49±22.36)mL、卧床时间(4.92±1.24)d、住院天数(8.35±1.76)d与B组[(244.03±20.71)mL、(5.03±1.10)d、(8.75±1.43)d]比较差异无统计学意义(P＞0.05);A 组手术时间(129.80±17.02)min 长于 B 组(122.95±15.63)min,差异有统计学意义(P＜0.05);在T2 时点,A组矢状面Cobb角、椎体高度压缩率、ODI均低于B组,差异有统计学意义(P＜0.05);两组术后24h、术后3d前列腺素E2(PGE2)、去甲肾上腺素(NE)比较差异无统计学意义(P＞0.05);两组术后并发症发生率比较差异无统计学意义(χ2=2.598,P=0.107).结论:经伤椎椎弓根6 钉固定术手术时间较长,但能更有效恢复A1 型胸腰椎骨折患者的脊柱稳定性,改善功能障碍.
Abstract
Objective:To study the effects of different internal fixation operations on the spinal stability of A1 thoracolumbar fracture.Methods:A retrospective analysis was conducted on the clinical data of 146 pa-tients with A1 type thoracolumbar fractures treated in our hospital from January 2021 to January 2023.Based on the method of internal fixation surgery,82 patients who underwent six-screw transpedicular fixation were included in Group A,and 64 patients who underwent four-screw transpedicular fixation were included in Group B.Perioperative indicators,sagittal Cobb angle,vertebral height compression rate,Oswestry Disability Index(ODI),stress indicators,and postoperative complications were compared between the two groups.Re-sults:No significant differences were found between Group A and Group B in terms of intraoperative blood loss(248.49±22.36 mL vs.244.03±20.71 mL),bed rest duration(4.92±1.24 days vs.5.03±1.10 days),and hospital stay length(8.35±1.76 days vs.8.75±1.43 days)(P＞0.05).The surgery time was signifi-cantly longer in Group A(129.80±17.02 minutes)compared to Group B(122.95±15.63 minutes)(P＜0.05).At the T2 time point,the sagittal Cobb angle,vertebral height compression rate,and ODI were signifi-cantly lower in Group A than in Group B(P＜0.05).There were no significant differences in the levels of prostaglandin E2(PGE2)and norepinephrine(NE)between the two groups at 24 hours and 3 days postoper-atively(P＞0.05).The incidence of postoperative complications did not differ significantly between the two groups(χ2=2.598,P=0.107).Conclusion:Although the six-screw transpedicular fixation surgery has a longer duration,it more effectively restores spinal stability and improves functional outcomes in patients with A1 type thoracolumbar fractures.
关键词
经伤椎椎弓根6钉/跨伤椎4钉置钉/A1型胸腰椎骨折/脊柱稳定性Key words
Pedicle 6-screw through injured vertebra/Pedicle 4-screw across the injured verte-bra/Type A1 thoracolumbar fractures/Spinal stability引用本文复制引用
基金项目
陕西省重点研发计划项目(2022SF-525)
出版年
2024
国家科技期刊平台
NSTL
万方数据